Binge-Eating Disorder: A Primer for Professional Counselors

Binge-Eating Disorder (BED) is a primary diagnosis listed in the Feeding and Eating Disorders chapter of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5; American Psychiatric Association [APA], 2013). Although BED is considered one of the most common eating disorders, symptoms often go unrecognized and untreated (Striegel-Moore et al. 2010). In this article, BED criteria are reviewed and guidelines for assessment, diagnosis, and treatment are offered. A case study is also provided to illustrate the application of BED utilizing best practices

Shear-free, Irrotational, Geodesic, Anisotropic Fluid Cosmologies

General relativistic anisotropic fluid models whose fluid flow lines form a shear-free, irrotational, geodesic timelike congruence are examined. These models are of Petrov type D, and are assumed to have zero heat flux and an anisotropic stress tensor that possesses two distinct non-zero eigenvalues. Some general results concerning the form of the metric and the stress-tensor for these models are established. Furthermore, if the energy density and the isotropic pressure, as measured by a comoving observer, satisfy an equation of state of the form $p = p(\mu)$, with $\frac{dp}{d\mu} \neq -\frac{1}{3}$, then these spacetimes admit a foliation by spacelike hypersurfaces of constant Ricci scalar. In addition, models for which both the energy density and the anisotropic pressures only depend on time are investigated; both spatially homogeneous and spatially inhomogeneous models are found. A classification of these models is undertaken. Also, a particular class of anisotropic fluid models which are simple generalizations of the homogeneous isotropic cosmological models is studied.Comment: 13 pages LaTe

Adherence of Mobile App-Based Surveys and Comparison With Traditional Surveys: eCohort Study

BACKGROUND: eCohort studies offer an efficient approach for data collection. However, eCohort studies are challenged by volunteer bias and low adherence. We designed an eCohort embedded in the Framingham Heart Study (eFHS) to address these challenges and to compare the digital data to traditional data collection. OBJECTIVE: The aim of this study was to evaluate adherence of the eFHS app-based surveys deployed at baseline (time of enrollment in the eCohort) and every 3 months up to 1 year, and to compare baseline digital surveys with surveys collected at the research center. METHODS: We defined adherence rates as the proportion of participants who completed at least one survey at a given 3-month period and computed adherence rates for each 3-month period. To evaluate agreement, we compared several baseline measures obtained in the eFHS app survey to those obtained at the in-person research center exam using the concordance correlation coefficient (CCC). RESULTS: Among the 1948 eFHS participants (mean age 53, SD 9 years; 57% women), we found high adherence to baseline surveys (89%) and a decrease in adherence over time (58% at 3 months, 52% at 6 months, 41% at 9 months, and 40% at 12 months). eFHS participants who returned surveys were more likely to be women (adjusted odds ratio [aOR] 1.58, 95% CI 1.18-2.11) and less likely to be smokers (aOR 0.53, 95% CI 0.32-0.90). Compared to in-person exam data, we observed moderate agreement for baseline app-based surveys of the Physical Activity Index (mean difference 2.27, CCC=0.56), and high agreement for average drinks per week (mean difference 0.54, CCC=0.82) and depressive symptoms scores (mean difference 0.03, CCC=0.77). CONCLUSIONS: We observed that eFHS participants had a high survey return at baseline and each 3-month survey period over the 12 months of follow up. We observed moderate to high agreement between digital and research center measures for several types of surveys, including physical activity, depressive symptoms, and alcohol use. Thus, this digital data collection mechanism is a promising tool to collect data related to cardiovascular disease and its risk factors

A 4-week resistance training intervention improves stability, strength and neuromuscular activity in the lower limb: a case study of a cerebral palsy adult

Spastic diplegia, a form of cerebral palsy, is a neurological disorder that results in some degree of spasticity. It is often associated with impairment of both normal and selective movement of the lower limbs, and some degree of muscular weakness. Resistance training is an established exercise intervention with numerous neurological benefits. Evidence suggests that resistance training can positively improve stability in young populations with cerebral palsy. However, little research exists in adult populations, who are at greater risk of inactivity due to ageing and an increase in sedentarism. A single-subject (aged 35-years old, 150.5 centimetres, 81 kilograms) case-study was therefore carried out to investigate the effectiveness of a 4-week resistance training intervention on stability, neuromuscular activity and force output in a male adult with cerebral palsy. The variables measured were total centre of pressure displacement, peak torque in both the quadriceps and hamstrings and Surface Electromyography (sEMG) activity in the Rectus Femoris (RF), Vastus Lateralis (VL), Biceps Femoris (BF) and Semitendinosus (ST). The results demonstrated that a 4-week resistance training intervention reduced total centre of pressure displacement (-51.34%) whilst concomitantly increased sEMG output (RF left +80% right +22%, VL left +160% right +26%, BF left +203% right +44%, ST left +40% right +90%) and peak torque values (right leg extension -7%, right leg flexion +29%, left leg extension +11%, left leg flexion +42%). In conclusion, this case study demonstrates that a 4-week resistance training intervention improves the stability of the participant, possibly through neurological adaptations and improvements to lower limb strength

Very long optical path-length from a compact multi-pass cell

The multiple-pass optical cell is an important tool for laser absorption spectroscopy and its many applications. For most practical applications, such as trace-gas detection, a compact and robust design is essential. Here we report an investigation into a multi-pass cell design based on a pair of cylindrical mirrors, with a particular focus on achieving very long optical paths. We demonstrate a path-length of 50.31 m in a cell with 40 mm diameter mirrors spaced 88.9 mm apart - a 3-fold increase over the previously reported longest path-length obtained with this type of cell configuration. We characterize the mechanical stability of the cell and describe the practical conditions necessary to achieve very long path-lengths

The specialty choices of graduates from Brighton and Sussex Medical School: a longitudinal cohort study

BACKGROUND Since 2007 junior doctors in the UK have had to make major career decisions at a point when previously many had not yet chosen a specialty. This study examined when doctors in this new system make specialty choices, which factors influence choices, and whether doctors who choose a specialty they were interested in at medical school are more confident in their choice than those doctors whose interests change post-graduation. METHODS Two cohorts of students in their penultimate year at one medical school (n = 227/239) were asked which specialty interested them as a career. Two years later, 210/227 were sent a questionnaire measuring actual specialty chosen, confidence, influence of perceptions of the specialty and experiences on choice, satisfaction with medicine, personality, self-efficacy, and demographics. Medical school and post-graduation choices in the same category were deemed 'stable'. Predictors of stability, and of not having chosen a specialty, were calculated using bootstrapped logistic regression. Differences between specialties on questionnaire factors were analysed. RESULTS 50% responded (n = 105/277; 44% of the 239 Year 4 students). 65% specialty choices were 'stable'. Factors univariately associated with stability were specialty chosen, having enjoyed the specialty at medical school or since starting work, having first considered the specialty earlier. A regression found doctors who chose psychiatry were more likely to have changed choice than those who chose general practice. Confidence in the choice was not associated with stability. Those who chose general practice valued lifestyle factors. A psychiatry choice was associated with needing a job and using one's intellect to help others. The decision to choose surgical training tended to be made early. Not having applied for specialty training was associated with being lower on agreeableness and conscientiousness. CONCLUSION Medical school experiences are important in specialty choice but experiences post-graduation remain significant, particularly in some specialties (psychiatry in our sample). Career guidance is important at medical school and should be continued post-graduation, with senior clinicians supported in advising juniors. Careers advice in the first year post-graduation may be particularly important, especially for specialties which have difficulty recruiting or are poorly represented at medical school

Increase in the proportion of patients hospitalized with acute myocardial infarction with do-not-resuscitate orders already in place between 2001 and 2007: a nonconcurrent prospective study

BACKGROUND AND OBJECTIVE: Shared decision making and advance planning in end-of-life decisions have become increasingly important aspects of the management of seriously ill patients. Here, we describe the use and timing of do-not-resuscitate (DNR) orders in patients hospitalized with acute myocardial infarction (AMI). STUDY DESIGN AND SETTING: The nonconcurrent prospective study population consisted of 4182 patients hospitalized with AMI in central Massachusetts in four annual periods between 2001 and 2007. RESULTS: One-quarter (25%) of patients had a DNR order written either prior to or during hospitalization. The frequency of DNR orders remained constant (24% in 2001; 26% in 2007). Among patients with DNR orders, there was a significant increase in orders written prior to hospitalization (2001: 9%; 2007: 55%). Older patients and those with a medical history of heart failure or myocardial infarction were more likely to have prior DNR orders than respective comparison groups. Patients with prior DNR orders were less likely to die 1 month after hospitalization than patients whose DNRs were written during hospitalization. CONCLUSION: Although the use of DNR orders in patients hospitalized with AMI was stable during the period under study, in more recent years, patients are increasingly being hospitalized with DNR orders already in place